Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00579 | Date 19/12/2019 |
| Token No | SM/19-20/1253 24/12/2019 | Serial | 010 |
| Patient Name | Mrs. RANI ROY | Contact No | 8580004702 |
| Address | TARA PUKUR QUATER | Age | 16 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||